Learning Objectives for this Presentation:
By the end of this presentation participants will be able to identify physician-rated most appropriate venues for administration of influenza vaccine and have a better understanding of problems associated with vaccine supply issues in primary care.

Background:
Physician members of the American Academy of Family Physicians (AAFP) provide influenza vaccine to millions of American each year. Moreover, family physicians (FPs) directly experience practice-centered issues associated with vaccine delays and shortages.

Objectives:
To better define usual administration of influenza vaccine, the AAFP—through a CDC cooperative agreement—conducted three annual membership surveys.

Methods:
Surveys were mailed to randomly selected samples of clinically-active AAFP members in 2004 (n=2192), 2005 (n=4720), and 2006 (n=5000) and contained 5, 10 and 9 questions pertaining to influenza issues, respectively. Summary statistics were evaluated. Approaches were compared between years and among demographic groups using chi square and ANOVA as appropriate.

Results:
Modest return rates were achieved (2004: 46.5%; 2005: 48.3%; 2006: 52.4%). FPs identified physician offices (98.6%), nursing homes (95.8%), public health clinics (95.3%) and hospitals (93.6%) as appropriate venues for influenza vaccine administration. Pharmacies (44.3%) and retailers (26.5%) were viewed as less appropriate. During the 2005-2006 influenza season (delayed vaccine), 32% had vaccine left over at the end of season; 17.9% reported problems with ordering for 2006-2007. Over three years, a decline in clinic employees routinely immunized occured (P<0.001). Despite delays and shortages, a majority and increasing percentage of FPs favor a recommendation for universal influenza vaccination if supplies are adequate and assured (2005: 67.6% vs. 2006: 69.5%; P<0.001). Moreover, fewer FPs in 2006 had concerns regarding thimerosal than in 2005 (18.0% vs.21.0%; P<0.001).

Conclusions:
FPs are supportive of influenza vaccination and are an essential component of the influenza prevention system, but are highly susceptible to delays and shortages in vaccine.